From inside the ER: B.C. doctor tells it like it is from the frontlines of COVID-19

Dr. Marc Greidanus is a front line health worker facing the COVID-19 crisis as an emergency room doctor at Chilliwack General Hospital.

As a service to the community, he agreed to speak with Black Press Media’s publication, The Progress, to share some key information.

The Progress: What is essential for people to know?

Dr. Greidanus: The most important message from our perspective: Stay home. Wash your hands. Stop everything except work and groceries. Go for walks but only with your own household members.

P: In this time of COVID-19, who should come to the ER and when?

G: This is a really delicate question. Overall, if you are having chest pain or stomach pain or difficulty breathing or have an injury, absolutely we want to see you! Please don’t be afraid of coronavirus in the ER. We are taking precautions. The ER is a safe place and we don’t want you to have your heart attack at home.

On the flip side, if you have a cough but you are breathing OK and not feeling faint, and the reason you are coming is that you are worried about COVID, we will not test you. We will tell you to stay home for 14 days. If you are coughing and feeling short of breath or lightheaded, please come in. If you are unsure you can use the online BC COVID-19 self assessment tool, phone 811.

P: Should there be more testing done?

G: To be clear we are not withholding tests. B.C. is testing at capacity. We are using that capacity to test healthcare workers, long-term care residents and close contacts of known positive patients. This is enough to give us reliable data. As more testing capacity becomes available we will test more broadly.

P: People are a little confused on the lethality. Isn’t COVID-19 just a bad flu?

G: While it is true that novel coronavirus and the resulting illness (COVID-19) is not as lethal as ebola or SARS, it is still much more dangerous than influenza. The risk is highest in older people and those with other health problems but the biggest risk is to the integrity of our health care system.

Social distancing is the only way that we can get this virus under control. That means cancelling everything except work and groceries and staying by yourself or with your household.

P: Should people exercise outdoors?

G: Yes it is safe to go outside. Walking around town, by the river or on our many trails is very low risk and Chilliwack is blessed with wide open spaces. Please be considerate and always maintain a distance of at least two metres (six feet) between yourself and others. Control your kids. Control your dog. Stick to your local areas and don’t take risks.

P: Should folks wear gloves?

G: Wearing gloves is not helpful unless you change them between every activity. It is much more useful to wash your hands often and avoid touching your face.

P: What about masks. Should folks wear them even if they are not sick?

G: There is reasonable evidence that masking the general public is useful in a pandemic, however we currently do not have enough medical-grade masks in Canada to supply our healthcare workers through the next month so first we need to address supply issues.

Homemade masks are less effective than medical grade masks, but they are much better than nothing. Remember that wearing a mask is more about protecting others from you. A homemade mask absolutely helps you keep your snot and saliva to yourself. If you touch your mask you need to wash your hands.

It is not the official recommendation but it is my opinion based on the evidence that everyone should consider wearing some sort of self-sourced face covering when in public spaces like grocery stores.

P: How long is this nightmare going to last?

G: I believe this pandemic will be affecting our daily lives until a vaccine or treatment is widely available, which could be 18 months. However if we get it right the most severe restrictions only need to be in place for another month or two. Then as we develop the capacity to test more people we can gradually reduce restrictions and observe the results.

P: How is the stress of being a healthcare worker during a pandemic?

G: For us in Emerg, this is our turf. I have a high risk tolerance. Those of us who work in emergency medicine are there for a reason. Personally I am not particularly stressed about my health or the health of my family. When I do fret, it is about our systems and my individual patients.

I want to do my best for people and I don’t want to see the healthcare system overwhelmed. Also I am worried about the long-term effects on our already isolated society. My thoughts are with the grocery store clerks and cleaners and other front line workers who never signed up for this risk. But we are all in it together now.

P: Any final thoughts for readers who’ve made it this far?

G: Yes. Stay home. It’s working. And please don’t worry. Your job is to stay home and wash your hands. You can do it. Our government is stable. Our systems are strong. Canada has got this. B.C. has got this. CGH and the local healthcare community have got this.